LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT DAN BHP

PUSKESMAS : Tamangapa PELAPORAN : Desember 2016

KECAMATAN : Manggala
KOTA : Makassar
N0 HP : 081342389977
EMAIL : suryanirudy@yahoo.co.id

SATUAN STOK STOK

NO NAMA OBAT DAN BHP PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEBUTUHAN
PERMINTAAN
PEMBERIAN KET
AWAL OPTIMUM
JAMINAN KESEHATAN NASIONAL 2015
I. OBAT JKN 2015
1 Allopurinol tablet 100 mg Tablet - - - -
2 Ambroksol tablet Tablet 6155 6,155 395 5,760 474 (5,286)
3 Amoksisilin 500 mg kapsul Kapsul - - - -
4 Antasida Doen tablet Tablet - - - -
5 Asam Mefenamat tablet 500 mg Tablet - - - -
6 Asam Pipemidat kapsul Kapsul 50 50 10 40 12 (28)
7 Bedak Salisil Serbuk 2% Pot 89 89 31 58 37 (21)
8 Cefadroxil sirup kering 125 mg/5 ml Botol 125 125 9 116 11 (105)
9 Cetrizine tablet Tablet 3219 3,219 1,039 2,180 1,247 (933)
10 Dexamethasone injeksi Ampul 28 28 10 18 12 (6)
Botol
11 Dextrose 5% 500 ml - - - -
Botol
12 Dextrose 10% 500 ml - - - -
13 Dextrose 40% Vial - - - -
14 Dipenhidramin injeksi Ampul - - - -
15 Furosemid tablet Tablet - - - -
16 Garam Oralit Sacchet - - - -
17 Glibenclamid tablet Tablet - - - -
18 Glimepiride tablet 1 mg Tablet - - - -
19 Glimepiride tablet 2 mg Tablet - - - -
20 Hidrokortison krim Tube 10 g 0 - - - -
21 Hiosin Butilbromid injeksi 20 mg/ml Ampul - - - -
Botol
22 KA EN 3A 500 ml - - - -
Botol
23 KA EN 3B 500 ml - - - -
24 Ketokonazol tab 200 mg Tablet 230 230 30 200 36 (164)
25 Ketorolac injeksi Ampul - - - -
26 Lidokain comp. Injeksi Ampul - - - -
27 Metformin tablet Tablet 0 - - - -
28 Metil Ergometrin injeksi Ampul - - - -
29 Mometason furoat krim 0,1% Tube - - - -
Botol
30 NaCl 0,9% 500 ml 500 ml - - - -
31 Natrium Diklofenak tablet Tablet - - - -
32 Nifedipin tablet Tablet - - - -
33 Nikardipine injeksi Vial - - - -
34 Obat Anti TuberFDC Kategori I Paket - - - -
35 Obat Anti TuberFDC Kategori II Paket - - - -
36 Oksitoksin injeksi Ampul - - - -
37 Ondansentron tablet 4 mg Tablet - - - -
38 Ondansentron injeksi Ampul - - - -
39 Paracetamol tablet 500 mg Tablet 4978 4,978 2,697 2,281 3,236 955
40 Parasetamol tetes 60 mg/0,6 ml Tablet 0 - - - -
41 Permetrin Krim 5% Tube - - - -
42 Prednison tablet Tablet 4259 4,259 407 3,852 488 (3,364)
43 Propanolol tablet 40 mg Tablet - - - -
44 Propanolol tablet 10 mg Tablet - - - -
45 Ranitidin tablet Tablet 100 100 100 - 120 120
46 Ringer Laktat 500 ml Botol 0 - - - -
47 Simvastatin tablet Tablet - - - -
48 Vitamin Bcomp tablet Tablet - - - -
Tablet
49 Zinc tablet dispersible 20 mg Disp - - - -
II. BHP JKN 2015 - - - -
50 AXIMED IV-CATH WP with wings & port (No. 18) Pcs 2 2 2 - (2)
51 AXIMED IV-CATH WP with wings & port (No. 20) Pcs 2 2 2 - (2)
52 AXIMED IV-CATH WP with wings & port (No. 26) Pcs 2 2 2 - (2)
53 Elektroda Pack - - - -
54 ETT Anak No. 2,4 mm Pcs - - - -
55 ETT Anak No. 3 mm Pcs - - - -
56 ETT Anak No. 3,5 mm Pcs - - - -
57 ETT Dewasa No. 6,5 mm Pcs - - - -
58 ETT Dewasa No. 7 mm Pcs - - - -
59 ETT Dewasa No. 7,5 mm Pcs - - - -
60 Folay Cateter Anak No. 6 Pcs 2 2 2 - (2)
61 Folay Cateter Anak No. 8 Pcs 2 2 2 - (2)
62 Folay Cateter Anak No. 10 Pcs 2 2 2 - (2)
63 Folay Cateter Anak No. 12 Pcs 2 2 2 - (2)
64 Folay Cateter Dewasa No. 14 Pcs 2 2 2 - (2)
65 Folay Cateter Dewasa No. 16 Pcs 2 2 2 - (2)
66 Folay Cateter Dewasa No. 18 Pcs 2 2 2 - (2)
67 Folay Cateter dewasa No.20 Pcs 2 2 2 - (2)
68 Folay Cateter Dewasa No.22 Pcs 2 2 2 - (2)
69 Gelang Nama untuk Bayi Pcs - - - -
70 Infus Set Set - - - -
71 IV Catheter 18 Pcs - - - -
72 IV Catheter 20 Pcs 20 20 - 20 - (20)
73 IV Catheter 16 Pcs - - - -
74 IV Catheter 26 Pcs - - - -
75 Kapas Lidi untuk IVA Pcs - - - -
76 Kertas EKG Roll - - - -
77 Kertas Film Roll - - - -
78 K-Y Jelly Tube 80 ml - - - -
79 Maag Slang Anak No. 3.5 Pcs 3 3 3 - (3)
80 Maag Slang Anak No. 5 Pcs 3 3 3 - (3)
81 Maag Slang Anak No. 8 Pcs 3 3 3 - (3)
82 Maag Slang Anak No. 10 Pcs - - - -
 83 Maag Slang Dewasa No. 12 Pcs 3 3 3 - (3)
84 Maag Slang Dewasa No. 14 Pcs 3 3 3 - (3)
85 Maag Slang Dewasa No. 16 Pcs 3 3 3 - (3)
86 Maag Slang Dewasa No. 18 Pcs 3 3 3 - (3)
87 Masker Pcs - - - -
88 Masker Oksigen Dewasa Pcs - - - -
89 O2 Binasal Anak Pcs - 2 - (2)
90 O2 Binasal Dewasa Pcs - 1 - (1)
91 O2 RM anak Pcs - - - -
92 O2 RM Dewasa Pcs - - - -
93 O2 NMR anak Pcs - - - -
94 O2 Transfer 1 M3 Set - - - -
95 Penjepit Tali Pusat Bag - - - -
96 Perfussor Line White Pcs - - - -
97 Perfussor Line Balack Pcs - - - -
98 Signa Jelly Bottle @200 ml - - - -
99 Spatel Plastik Pcs - - - -
100 Speculum Disposible Pcs - - - -
101 Spoit 1 cc Pcs 50 50 50 - (50)
102 Spoit 5 cc Pcs 50 50 50 - (50)
103 Spoit 5 cc Pcs - - - -
104 Spoit 10 cc Pcs 41 41 41 - (41)
105 Spoit 20 cc Pcs 18 18 18 - (18)
106 Spoit 50 cc Pcs 5 5 5 - (5)
107 Suction Catheter Anak No.6 Pcs 2 2 2 - (2)
108 Suction Catheter Anak No.8 Pcs 2 2 2 - (2)
109 Suction Catheter Anak No. 10 Pcs 2 2 2 - (2)
110 Suction Catheter dewasa No.12 Pcs 2 2 2 - (2)
111 Suction Catheter Dewasa No.14 Pcs 2 2 2 - (2)
112 Suction Catheter Dewasa No.16 Pcs 2 2 2 - (2)
113 Suction Catheter Dewasa No. 18 Pcs 2 2 2 - (2)
114 Three Way Buntut Pcs 2 2 2 - (2)
115 Three Way Non buntut Pcs 2 2 2 - (2)
116 Tracheo Life Pcs - - - -
117 Transfusi set Pcs 1 1 1 - (1)
118 Urine Bag Set 2 2 1 1 1 0
ASKES 2013 DANA 2015 - - - -
119 Hidrokartison krim 2,5 % Tube - - - -
120 Kombinasi tablet salut: besi (II) sulfat 7H20 200 Tablet - - - -
121 Miconazole krim/salep 2 % (Nitrat) Tube 2 2 2 - 2 2
122 Nifedipin tablet 10 mg Tablet - - - -
123 Parasetamol tablet 500 mg Tablet - - - -
124 Retinol (Vitamin A) tablet 100.000 IU Tablet - - - -
125 Vitamin B Kompleks tablet Tablet - - - -
DAK 2015 - - - -
126 Digoksin tablet 0,25 mg Tablet 195 195 195 - (195)
127 Doksisilin tablet Tablet - - - -
128 Epinefrin (Adrenalin) injeksi i.v/s.k/i.m 1 mg/ml Ampul - - - -
129 Fitomenadion (Vitamin K1) injeksi i.m 2 mg/ml Ampul - - - -
130 Tablet 2,620 2,610
Fitomenadion (Vitamin K1) tablet salut gula 10 mg 2620 10 12 (2,598)
131 Ibuprofen tablet 200 mg Tablet - - - -
132 Kalsium Laktat (Kalk) tablet 500 mg Tablet - - - -
133 Klorpromazin tablet salut 100 mg (HCl) Tablet - - - -
134 Natrium Diklopenak tablet 50 mg Tablet 2450 2,450 200 2,250 240 (2,010)
135 Ondansetron tablet 4 mg Tablet 1050 1,050 - 1,050 - (1,050)
136 Salbutamol tablet 4 mg (sebagai Sulfat) Tablet 645 645 35 610 42 (568)
137 Sianokobalamin (Vitamin B12) tablet Tablet - - - -
PROGRAM 2015 - - - -
138 Albendazole tablet 400 mg Tablet 961 961 4 957 5 (952)
139 Garam Oralit Sachet - - - -
140 Gentamicin injeksi 40 mg/ml Ampul - - - -
141 Isoniazid tablet 100 mg Tablet - - - -
142 Obat FDC Kategori Anak Paket - - - -
143 Reagen Zn (Program) Kit - - - -
144 Retinol 100.000 IU kapsul lunak Kaps Luna 400 400 400 - (400)
145 Retinol 200.000 IU kapsul lunak Kaps Luna 9000 9,000 9,000 - (9,000)
PG 2015 - - - -
I. OBAT PG 2015 - - - -
146 Alkohol 70% Botol 5 5 3 2 4 2
147 Botol 60 273 200
Ambroxol sirup ml 273 73 88 (112)
148 Ambroxol tablet Tablet - - - -
149 Aminophilin injeksi 24 mg/ml Ampul - - - -
150 Amiodaron injeksi Ampul - - - -
151 Amitriptiline tablet Tablet 100 100 100 - (100)
152 Amoksisilin kaplet 500 mg Kaplet - - - -
153 Amoksisilin sirup kering forte 250 mg/5ml Botol 60 ml - - - -
154 Amoxicilin sirup kering 125 mg/5 ml Botol 60 ml - - - -
155 Antasida DOEN I tablet kunyah Tablet - - - -
156 Antasida DOEN II suspensi Botol 60 ml - - - -
Supposit
157 Antihemoroid suppositoria oria - - - -
158 Antimigren tablet Tablet 400 400 33 367 40 (327)
159 Asam Askorbat (Vitamin C) tablet 50 mg Tablet - - - -
160 Asam Folat tablet 1 mg Tablet 403 403 333 70 400 330
161 Asam Traneksamat injeksi 50 mg/ml Ampul - - - -
162 Atropin Sulfat injeksi Ampul - - - -
163 Bedak salisil serbuk 2 % Dus 50 g - - - -
164 Besi II Sulfat tablet Tablet 21010 21,010 1,960 14,940 2,352 (12,588) sdh s/d di 1960
165 Betahistin Mesylat tablet Tablet - - - -
166 Betametason krim 0,1% Tube - - - -
167 Bromhexin tablet Tablet - - - -
168 Budesonid inhaler 160/4.5 mcg (Symbicort) Dus 1 Turbuhaler - - - -
169 Budesonid inhaler 80/4.5 mcg (Symbicort) Dus 1 Turbuhaler - - - -
170 Budesonid respuler 0.25 mg/ml (Pulmicort) Respules - - - -
Botol
171 Cairan Ringer Laktat 500 ml 500 ml - - - -
172 Carbazokrom Na Sulfonat inj 10 cc Ampul - - - -
173 Carbazokrom Na Sulfonat tablet 30 mg Tablet - - - -
174 Deksametason tablet 0,5 mg Tablet - - - -
175 Deksametasone injeksi Ampul - - - -
176 Digoksin injeksi 0,25 mg/ml (Fargoxin injeksi) Ampul - - - -
177 Dobutamin injeksi 50 mg/ml Ampul - - - -
178 Doksisiklin kapsul 100 mg Kapsul - - - -
179 Domperidone suspensi Botol 60 m 45 45 13 32 16 (16)
180 Donperidone tablet 10 mg Tablet 867 867 100 767 120 (647)
181 Epinephrin (Adrenalin) injeksi Ampul - - - -
182 Fitomenadion (Vitamin K1) injeksi i.m. 2 mg/ml Ampul - - - -
183 Furosemid tablet 40 mg Tablet - - - -
Botol
184 Gelofusin - - - -
500 ml
185 21 21
Gentamisin Salep Mata 0.3 % (Genoint salep mata) Tube 3.5 g 21 - (21)
186 Gentian Violet Botol - - - -
187 Glukosa larutan infus 5% steril Botol - -
500 ml - -
188 Ibufrofen tablet 400 mg Tablet - - - -
189 Irbesartan tablet 300 mg Tablet - - - -
190 Isosorbid Dinitrat injeksi i.v 10 mg/10 ml(Farsorbid - -
injeksi) Vial - -
191 Kaptopril tablet 50 mg Tablet 804 804 100 704 120 (584)
192 Kaptopril tablet 25 mg Tablet - - - -
193 Ketokonazol krim 2% Tube 15 g - - - -
194 Kloramfenikol salep mata 1% Tube - - - -
195 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 32801 32,801 2,191 30,610 2,629 (27,981) 1271
196 Kodein tablet 10 mg Tablet - - - -
197 Komb tts mata 2,5 mg/ml; NaCl 8664 mg KCl 1.32 mg 28 28
(Cendo Lyters) Botol 15 m 28 - (28)
198 Kotrimoksazol suspensi Botol 60 ml - - - -
199 Kotrimoksazole Adult tablet Tablet - - - -
200 Lanzoprazole kapsul 30 mg Kapsul - - - -
201 Lidokain injeksi 2% Ampul - - - -
202 Loperamid tablet 2 mg Tablet 1500 1,500 138 1,362 166 (1,196)
203 Meloxicam tablet 15 mg Tablet - - - -
204 Metformin HCl tablet 500 mg Tablet - - - -
205 Metilprednisolon tablet 4 mg Tablet - - - -
206 Metoklopramida tablet 10 mg Tablet - - - -
207 Mikonazole krim 2% Tube 2 2 2 - (2)
208 Mometason furoat krim 0,1% Tube 10 g - - - - ***
Botol
209 Nacl 0,9% 500 ml 12 12 4 8 5 (3)
500 ml
210 NaCl 0.9 Piggy Bag Botol - - - -
211 Natrium Diklofenak tablet 50 mg Tablet 0 - - - - -
212 Nifedipin tablet 10 mg Tablet - - - -
213 Nikardipine injeksi Vial - - - -
214 Nistatin tablet salut 500.000 IU/ g Tablet 2850 2,850 2,420 430 2,904 2,474
215 Nistatin Vaginal tablet 100.000 IU/ g Vagtab - - - -
216 Norephinefrin injeksi 1 mg/ml (Levosol) Ampul - - - -
217 Obat Anti Tuberkulosis FDC Kategori 2 Paket 1 1 1 - (1)
218 Obat AntiTuberkulosis FDC Kategori 1 Paket 0 - - - -
219 Obat Antituberkulosis Kategori Anak Paket - - - -
220 Oksitoksin injeksi Ampul - - - -
221 Oksitetrasiklin salep mata Tube 59 59 2 57 2 (55)
222 Parasetamol sirup Botol - - - -
223 Parasetamol tablet 500 mg Tablet - - - -
224 Permetrin krim 5% Tube 10 g 7 7 1 6 1 (5)
225 Piridoksin (Vitamin B6) tablet 10 mg Tablet - - - -
226 Piroxicam tablet 10 mg Tablet 1884 1,884 24 1,860 29 (1,831)
227 Piroxicam tablet 20 mg Tablet - - - -
228 Prednison tablet 5 mg Tablet - - - -
229 Propiltiurasil tablet 100 mg Tablet - - - -
230 Ranitidin sirup Botol 60ml - - - -
231 Ranitidin tablet 150 mg Tablet - - - -
232 Ringer Laktat 500 ml Botol 500 ml - - - -
233 Salep 2-4 kombinasi Pot - - - -
234 Sefadroksil sirup kering 125 mg/ml Botol 60 ml - - - -
235 Sefiksim kapsul 100 mg Tablet - - - -
236 Setirizin tablet 10 mg Tablet - - - -
237 Sianokobalamin (Vitamin B12) tablet Tablet - - - -
238 Simvastatin scored tablet 10 mg Tablet - - - -
239 Siprofloksasin tablet 500 mg Tablet - - - -
240 Thiamin tablet Tablet - - - -
241 Thiampenicol kapsul Kapsul - - - -
242 Trihexyphenidyl tablet 2 mg Tablet 100 100 100 - (100)
243 Valsartan tablet 80 mg Tablet - - - -
244 Valsartan tablet 80 mg (Diovan tablet) Tablet - - - -
245 Vitamin B Kompleks tablet Tablet - - - -
246 Zinc tablet dispersible 20 mg Tablet - - - -
247 Zulfasalazin tablet Tablet - - - -
II BHP PG 2015 - - - -
248 Aguadest/Steril water Botol - - - -
249 Asam Sulfosalisilat 20 % Botol 100 ml - - - -
250 Bahan Pengobatan Pulpa Botol 13 ml - - - -
251 Bahan untuk Perawatan Syaraf Akar Gigi Botol 7.5 g - - - -
252 Blood Lancet Pcs 800 800 800 - (800)
253 Box Sampel Unit - - - -
254 Bulp Pcs - - - -
255 CHKM Botol 10 ml - - - -
256 Combur Test Botol 100 ml - - - -
257 Daryantule/Vaselin SW Pcs 0 - - - -
258 Etakridin 0,1% Botol 300 18 18 18 - (18)
259 Etanol 70% Botol 100 ml - - - -
260 Gelas Piala (Becker) 1000 ml Pcs - - - -
261 Gelas Piala (Becker) 500 ml Pcs - - - -
262 Hypafix/Plester Untuk Kesehatan Pcs - - - -
263 IV Cateter No. 20 G ( Jelco 20) Pcs - - - -
264 Jarum Injeksi Untuk Gigi Sekali Pakai Box 100 - -
pcs - -
265 Kalium Hidroksida Pasta Box@2tube 4 4 4 - (4)
266 Kapas Lemak (Ahmadaris DRC 500 g) Rol - - - -
267 Kasa Pembalut (Ahmadaris DRC 4 x 10 cm) Rol - - - -
268 Keranjang Sampel Pcs - - - -
269 Lampu Spiritus Pcs - - - -
270 Lap Halus Pcs - - - -
271 Lap Kasar Pcs - - - -
272 Larutan Barium Klorida 10 % Botol 100 ml - - - -
273 Larutan Benedict Botol 100 ml - - - -
274 Larutan Eosin Botol 100 ml - - - -
275 Larutan Faucthet Botol 100 ml - - - -
276 Larutan Hayem Botol 100 ml - - - -
277 Larutan HCl 0,1 N Botol 100 ml - - - -
278 Larutan Injeksi untuk Gigi Ampul - - - -
279 Larutan Rockles Botol 100 ml - - - -
280 Larutan Turk Botol 100 ml - - - -
281 Masker N 95 Pcs - - - -
282 Object Glass Box - - - -
283 Paket Pewarna Gram Botol 100 ml - - - -
284 Pipet Tetes Pcs - - - -
285 Plester Anti Air Pcs - - - -
286 Pot Dahak Pcs 96 96 96 - (96)
287 Rapid Tes Demam Berdarah (NSI) Box 25 test - - - -
288 Rapid Test Gonorrhoea Box 25 test - - - -
289 Rapid Test HIV 1/2 Antibodi Box 100 - -
test - -
Box @
290 Rapid Test HIV advance quality 40 test - - - -
Box 100
291 Rapid Test Syphilis - - - -
test
292 Rapid Test Vikia 1/2 Box 25 test - - - -
Set 25
293 Reagen SO4 (14548) Test - - - -
Set @
294 Reagensia Test PH 150 Test - - - -
295 Reagen Ziehl Neelsen Botol 100 ml - - - -
 Set @
296 Reagensia Florida (F) 100 test - - - -
Botol @
297 Reagensia LB 500 g - - - -
298 Reagensia Mangan (Mn) 14770 Set@500 Test - - - -
299 Sabun Cuci Alat Botol - - - -
300 Safety Box 5 Liter Pcs - - - -
301 Sikat Tabung Pcs - - - -
302 Spoit untuk Imunisasi 0.05 cc Pcs - - - -
303 Stes Kit Makanan dan Minuman Tube@25 strip - - - -
304 Strip Cholesterol Stripe - - - -
305 Strip Glucose Stripe - - - -
306 Strip Uric Acid Stripe - - - -
307 Tabung Reaksi Ulir Pcs - - - -
308 Tambalan Sementara Pot 30 g - - - -
309 Tes Golongan Darah Kit 6 vial - - - -
310 Tes Widal Kit 8 vial - - - -
Box @
311 Wing Needle 100 pcs 65 65 65 - (65)
312 Zinc Phosphate Cement Liquid Botol 10 ml - - - -
313 Zinc Phosphate Cement Powder Botol 30 g - - - -
SISA SALDO DES 14 KE DES 15 - - - -
ASKESJKN DES 14 KE DES 15 - - - -
314 Asiklovir tab 200 mg Tablet - - - -
315 Asiklovir tab 400 mg Tablet 645 645 645 - (645)
316 Adona inj Ampul - - - -
317 Asiklovir tab 400 mg Tablet - - - -
318 - - retur GFK
Adalat oros tab 20 mg Tablet - - (ED)
319 Alopurinol tab 100 mg Tablet - - - -
320 Ambroksol 30 mg tab Tablet - - - -
321 Amlodipin tab 5 mg Tablet - - - -
322 Amlodipin tab b10 mg Tablet - - - -
323 Amoksisillin sirup kering 125 mg/5ml Botol 60 ml - - - -
324 Amoksisillin kapsul 500 mg Kapsul - - - -
325 Analsik tab Tablet 15 15 15 - 18 18
326 Antalgin tab 500 mg Tablet 7394 7,394 360 7,034 432 (6,602)
327 Antasida tablet Tablet - - - -
328 AntifungiDOEN Kombinasi Pot - - - -
329 Anti Hemorroid Suppo - - - -
330 Asam Askorbat 250 mg tab Tablet - - - -
331 Asering inf Plastic Bottle 500 ml - - - -
332 Asetosal tab 500 mg Tablet - - - -
333 Atropin Sulfat tablet Tablet - - - -
334 Atropin Sulfat injeksi Ampul - - - -
335 Besi (II) Sulfat 100 zak 30 tab - - - -
336 Bioplacenton Jelly Tube - - - -
337 Bromhexin tab Tablet - - - -
338 Carbazocrome Na Sulfonate inj 10 cc ampul - - - -
339 Carbazocrome Na Sulfonate Tablet 30 mg Tablet - - - -
340 Captopril tab 25 mg Tablet - - - -
341 Cendo Polydex Botol 1 1 1 - 1 1
342 Cetrizine 10 mg tab Tablet - - - -
343 Cimetidin tab Tablet - - - -
344 Ciprofloxasin 500 mg Tablet - - - -
345 Deksametason tab Tablet - - - -
346 Deksametason inj 5 mg Ampul - - - -
347 Diazepam inj Ampul - - - -
348 Diovan 80 mg tab (Valsartan tab) Tablet 0 - - - -
349 Donperidon sirup Botol 60 ml - - - -
350 Donperidon tablet Tablet - - - -
351 Elkana Tablet - - - -
352 Fenilbutason tab Tablet - - - -
353 Flamar Gel Tube - - - -
354 Gentamicin tetes mata 0.3 % Dus , botol plastik 5 ml - - - -
355 Glimepiride tab 2 mg Tablet - - - -
356 Glimepiride tab 2 mg Tablet - - - -
357 Griseofulvin tab Tablet - - - -
358 Fenobarbital tab 30 mg Tablet - - - -
359 Fitomenadion (Vitamin K1) tab sal gula 10 mg Tablet - - - -
360 Fitomenadion (Vitamin K1) inj Ampul - - - -
361 Hyoscin Butilbromide inj Ampul - - - -
362 Ibuprofen tab 200 mg Tablet - - - -
363 Ibuprofen tab 200 mg Tablet - - - -
364 Ibuprofen tab 400 mg Tablet - - - -
365 Ibuprofen suspensi Botol - - - -
366 Irbesartan tab 300 mg Tablet - - - -
367 KAEN 3 A Plastic Bottle 500 ml - - - -
368 KAEN 3 B Plastic Bottle 500 ml - - - -
369 Kalium Diklofenak tab 50 mg Tablet - - - -
370 Kalsium Laktat Tablet - - - -
371 Ketoprofen tablet Tablet - - - -
372 Ketokonazole tablet Tablet - - - -
373 Klonidin tablet Tablet - - - -
374 Kloramfenikol tetes telinga Botol - - - -
375 Kotrimoksazol 480 mg tab Tablet - - - -
376 Lacto B Sachet - - - -
377 Lidokain komp inj Ampul - - - -
378 Meloxicam 7.5 mg Tablet - - - -
379 Mikonazol krim/salep 2 % Nitrat Tube 10 g - - - -
380 Metilergometrin maleat Tablet - - - -
381 Metilergometrin maleat Ampul - - - -
382 Metronidazole 500 mg tab Tablet - - - -
383 Metilprednisolon tab 4 mg Tablet - - - -
384 Metformin tab Tablet - - - -
385 Mometasone salep 10 g Tube 10 g - - - -
386 Natrium Diklofenak Tablet - - - -
387 Neurodex Tablet - - - -
388 Nistati tab 500.00 iu Tablet - - - -
389 Nonflamin Kapsul - - - -
390 Oksitosin inj Ampul - - - -
391 Obat Batuk Hitam (OBH) 100 ml Botol - - - -
392 Oksitetrasiklin zk 3 % Tube - - - -
393 Oksitetrasiklinn sm 1 % Tube - - - -
394 Omeprazole tab Tablet - - - -
395 Otolin tts telinga Botol 10 cc - - - -
396 Prednison Tablet - - - -
397 Parasetamol tetes 60 mg/0.6 ml Botol 15 ml - - - -
398 Primolut N Tablet - - - -
399 Piroksikam 20 mg tab Tablet - - - -
400 Ranitidin tab Tablet - - - -
401 Retinol 200.000 IU Tablet - - - -
402 Salbutamol tablet 4 mg Tablet - - - -
403 Bedak Salisil Serbuk 2 % Dus - - - -
404 Salep 2-4 Pot - - - -
405 Sefadroksil syrup Botol 60 ml - - - -
406 Suppositoria untuk anak yang mengandung diazepam 5 Tube - - - -
407 Sianokobalamin tab Tablet - - - -
408 Simvastatin 10 mg tab Tablet - - - -
Sirup obat batuk dengan komposisi: Tiap 5 cc
mengandung Dipenhidramin HCl 5 mg ,
Dextromethorpan HBr 7.5 mg , Fenilpropanolamin HCl
409 7.5 mg, Ammonium Clorida 62.5 mg, Natrium Sitran 25 - -
mg, Citroen Flavored syrup qs (Pyridril Syrup)

Botol 60 ml - -
410 Thiamin tablet Tablet - - - -
411 Thiamphenicol Tablet - - - -
Vitamin untuk anak-anak yang terdiri dari Vit A 5000
iu, vit A 5000 iu, vit B1 3 mg, Vit B2 2 mg, Vit B6 1 mg,
Vit B12 5 mcg, vit D1000 iu, d-phantenol 3 mg, i-lysin
412 HCl 300 mg, niamicinamide 20 mg (Biolysin Syrup) - -

Botol - -
413 Zink tablet Tablet - - - -
 DAK DES 2014 KE DES 2015 - - - -
414 Aciklovir 200 mg tab Tablet - - - -
416 Aciklovir 400 mg tab Tablet - - - -
417 Aciklovir krim 5 % Tube 0 - - - -
418 Alopurinol tab 100 mg Tablet - - - -
419 Ambroksol sirup Botol 60 ml - - - -
420 Amoksisilin kaplet 500 mg Tablet - - - -
421 Antalgin tab 500 mg Tablet - - - -
422 Antasida tab Tablet 7135 7,135 1,551 5,584 1,861 (3,723) 1707
423 Anti bakteri DOEN salep Tube 156 156 38 118 46 (72)
424 Antihaemorroid Suppositoria - - - -
425 Asam Askorbat 250 mg tablet Tablet - - - -
426 Asam Askorbat 50 mg tablet Tablet - - - -
427 Asetosal tablet 100 mg Tablet - - - -
428 Besi II Sulfat Tablet - - - -
429 Betametason krim Tube - - - -
430 Bledstop Tablet - - - -
431 Bromhexin tablet 8 mg Tablet - - - -
432 Bromifar tablet Tablet - - - -
433 Cetrizin tab 10 mg Tablet - - - -
434 Cimetidin tab Tablet - - - -
435 Dexametasone tab 0.5 mg Tablet - - - -
436 Doksisiklin caps Kapsul - - - -
437 Ephinefrin HCl Ampul - - - -
438 Fenilbutason Tablet 950 950 950 - (950)
439 Garam oralit Sachet - - - -
440 Gentaimisin salep kulit Tube - - - -
441 Gentian Violet Botol - - - -
442 Glibenklamide tab 5 mg Tablet - - - -
443 Glimepiride tab 2 mg Tablet - - - -
444 Gliseril guayakolat tab 100 mg Tablet 5987 5,987 1,597 4,390 1,916 (2,474) 1527
445 Griseofulvin tablet Tablet - - - -
446 Hidrokortison krim 2.5 % Tube - - - -
447 Hyoscine tab Tablet 260 260 100 160 120 (40)
448 Ibuprofen 400 mg tab Tablet - - - - 1075
449 Isosorbid Dinitrat tab sublingual 5 mg Tablet - - - -
450 Kalsium Laktat Tablet - - - -
451 Klorfeniramin maleat (CTM) tab 4 mg Tablet - - - -
452 Kotrimoksazol 120 mg Tablet - - - -
453 Kotrimoksasol 480 Tablet 2535 2,535 197 2,338 236 (2,102)
454 Kotrimoksasol suspensi Botol 60 m 75 75 26 49 31 (18)
455 Lidokain komp. Inj Ampul - - - -
456 Meloksikam 7.5 mg tab Tablet - - - -
457 Metformin tab 500 Tablet - - - -
458 Metil Prednisolon 4 mg tab Tablet - - - -
459 Metoklopropamide tab 10 mg Tablet 300 300 300 - (300)
460 Metronidazol 500 mg Tablet - - - -
461 Natrium klorida 0.9 % steril Botol 500 ml - - - -
462 Nistatin tab vaginal 100.000 IU/g Vagtab - - - -
463 Nutrifar Tablet - - - -
464 Oksitetrasiklin salep kulit Tube - - - -
465 Oksitetrasiklin salep mata Tube - - - -
466 Omeprazole 20 mg tab Tablet - - - -
467 Ofloxacin tab 400 mg Tablet - - - -
468 Papaverin tab 40 mg Tablet 64 64 26 38 31 (7)
469 Parasetamol drops Botol 15 ml - - - -
470 Parasetamol tab 500 mg Tablet - - - -
471 Piracetam 1200 mg tab Tablet - - - -
472 Pirantel 125 mg tab Tablet 0 - - - -
473 Povidon iodida 10% Botol 300 ml - - - -
474 Propiltiourasil tab 100 mg Tablet - - - -
475 Ranitidin tab Tablet - - - -
476 Ringer laktat infus Botol 500 ml - - - -
477 Salbutamol 2 mg tablet Tablet - - - -
478 Salisil Bedak Pot - - - -
479 Scopma tablet Tablet - - - -
480 Sianokobalamin ( Vit.B12 ) tab Tablet - - - -
481 Sianokobalamin ( Vit.B12 ) tab Tablet - - - -
482 Tetracyclin caps Kapsul - - - -
483 Vitamin Bkompleks tab Tablet - - - -
OKT DAN PROGRAM DES 2014 KE DES 2015 - - - -
484 Alprazolam tab (DAK) Tablet 835 835 30 805 36 (769)
485 DMP tab (DAK) Tablet - - - -
486 Alprazolam tab (PG) Tablet - - - -
487 Kodein tab 10 mg Tablet - - - -
488 Gentamicin injeksi 40 mg/ml (Program) Ampul - - - -
489 Phenobarbital tab 30 mg Tablet - - - -
490 Phenobarbital inj 50 mg/ml (Program) Ampul - - - -
491 Tramadol 50 mg tab (ASK) Tablet - - - -
492 Tramadol 50 mg tab (ASK) Tablet - - - -
493 Trihexyphenidil tab (DAK) Tablet - - - -
494 Haloperidol 5 mg (DAK Tablet 200 200 200 - (200)
495 Haloperidol 5 mg (PG) Tablet - - - -
496 Haloperidol 1.5 mg tab (DAK) Tablet 200 200 200 - (200)
497 Diazepam 2 mg tab (PG) Tablet 370 370 80 290 96 (194)
498 Diltiazem tab Tablet - - - -
499 Amitriptilin tab (DAK) Tablet - - - -
500 Stesolid rectal 5 mg (DAK) Tube 0 - - - -
501 Klorpromazine tab (DAK) Tablet 0 - - - -
502 Perfenazin tab 4 mg (DAK) Kapsul - - - -
503 Obat FDC Anak (DAK) Paket - - - -
504 Obat FDC Kategori I (DAK) Paket - - - -
505 Obat FDC kategori II (DAK) Paket - - - -
506 Obat FDC Sisipan (DAK) Paket - - - -
507 Magnesium Sulfat inj 20 % (Program) Ampul - - - -
508 Magnesium Sulfat inj 40 % (Program) Ampul - - - -
509 Calcii Gluconas 100 mg/ml (Program) Ampul - - - -
510 Reagen Zn (Program) Kit - - - -
511 Reagen Zn (Program) Kit - - - -
512 Procain Penicillin inj (program) Vial - - - -
513 Garam Oralit (Program) Sacchet - - - -
514 Tes Golongan Darah Set - - - -
515 Zinc tablet(Program) Tablet - - - -
PG DES 2014 KE DES 2015 - - - -
516 Alkohol 70 % Botol 100 ml - - - -
Botol 60
517 Ambroksol syrup - - - -
ml
518 Ambroksol tab 30 mg Tablet - - - -
519 Aminophyllin injeksi Ampul - - - -
520 Amlodipin tab 10 mg Tablet - - - -
521 Amlodipin tab 5 mg Tablet - - - -
522 Amoksisilin kaplet 500 mg Tablet - - - -
Botol 60
523 Amoksisilin sirup kering 125 mg/5 ml - - - -
ml
524 Antalgin tab 500 mg Tablet - - - -
525 Antasida DOEN suspensi Botol - - - -
526 Antasida tab Tablet - - - -
527 Anti bakteri DOEN salep Tube 156 156 156 - (156)
528 Antimigran Tablet 380 380 100 280 120 (160)
529 Asam Askorbat 250 mg tab Tablet - - - -
530 Asam Askorbat tab 50 mg Tablet - - - - 2285
531 Asam mefenamat 500 mg Tablet 1175 1,175 1,055 120 1,266 1,146 1605 1486
532 Asetosal tab 100 mg Tablet 0 - - - - 3100
533 Asiklovir tab 400 mg Tablet - - - - 1104
534 Asiklovir tab 200 mg Tablet 4495 4,495 20 4,475 24 (4,451) 1000
535 Azithromizin tab Tablet - - - -
536 Benzatin Benzil Penicillin 2.4 jt /vial Vial - - - -
537 Betametason krim 0.1 % Tube - - - -
538 Bromhexin tablet Tablet - - - -
539 Cetrizin tab Tablet - - - -
540 Clindamycin 150 mg Tablet 70 70 70 - (70)
541 Dexa inj Ampul - - - -
542 Digoxin tab 0.25 mg Tablet 185 185 15 170 18 (152)
Botol 60
543 Donperidon suspensi/sirup 5 mg/5 ml - - - -
ml
544 Donperidon tab Tablet - - - -
545 Ekstrak beladon tab 10 mg Tablet - - - -
546 Erythromycin 500 mg caps bx 100 - - - -
547 Fenilbutason Tablet - - - -
548 Fluoconazole tab Tablet - - - -
549 Furosemide tab Tablet 4744 4,744 4,744 - (4,744)
550 Garam Oralit Sachet 2550 2,550 461 2,089 553 (1,536)
551 Gentamicin 0.3 % 0TM Botol - - - -
552 Glibenklamid tab Tablet - - - -
553 Glimepiride tab Tablet - - - -
554 Glukosa larutan infus 5 % botol 500 ml - - - -
555 Griseofulvin tab Tablet - - - -
556 Hidrokortison krim tube 24 - - - -
557 Ibuprofen tab 400 mg Tablet 1230 1,230 630 600 756 156
558 Irbesartan tab 150 mg Tablet - - - -
559 kalium Diklofenak tab 50 mg Tablet - - - -
560 Ketokonazole 2 % krim Tube 15 g 31 31 31 - (31)
561 Kloramfenikol salep mata 1 % Tube - - - -
562 Kloramfenikol tt 3 % Botol 5 ml - - - -
563 kloramphenicol susp.125 mg/ml Botol 60 ml - - - -
564 Klorfeniramin maleat (CTM) tab 4 mg Tablet 32801 32,801 2,191 30,610 2,629 (27,981)
565 Levofloksasin tablet 500 mg Tablet - - - -
566 Lidokain komp. Inj Ampul - - - -
567 Linkomisin kapsul 500 mg Kapsul - - - -
568 Loperamide tab Tablet - - - -
569 Metilprednisolon tab 4 mg Tablet - - - -
570 Metoklopropamida tab Tablet - - - -
571 Metronidazol tab 500 mg Tablet - - - -
572 Mikonazol cream 2 % Tube - - - -
573 Mometason Furuoat krim Tube - - - -
574 Nistatin tab vaginal 100.000 IU/g Vagtab - - - -
575 Omeprazole tab Tablet - - - -
576 Papaverin tab Tablet - - - -
577 Paracetamol sirup 120 mg/10ml Botol 60 ml - - - -
578 Parasetamol tab 500 mg Tablet - - - -
579 Povidon iodida 10% Botol 60 ml - - - -
580 Prednison tab Tablet - - - -
581 Propanolol tablet 40 mg Tablet - - - -
582 Propiltiourasil tab 100 mg Tablet - - - -
583 Ranitidin inj Ampul - - - -
584 Ranitidin tab 150 mg Tablet - - - -
585 Salbutamol 4 mg Tablet - - - -
586 Salbutamol serbuk inh 200 mcg Kapsul - - - -
587 Salbutamol serbuk inh 200 mcg/caps+rotahler Rotahaler - - - -
588 Salisil Bedak 2 % Pot - - - -
589 Scabimite krim Tube - - - -
590 Sefadroksil kapsul/kaplet 500 mg Kapsul - - - -
591 Sefaleksin kaps 500 mg Kapsul - - - -
592 Sefiksim kapsul 100 mg Kapsul - - - -
593 Sianokobalamin ( Vit.B12 ) tab Tablet - - - -
594 Simvastatin tablet Tablet - - - -
595 Siprofloksasin tablet Tablet - - - -
596 Thiamin HCl tab Tablet - - - -
597 Tiamfenikol 500 mg kaps Kapsul - - - -
598 Valsartan tab 160 mg Tablet - - - -
599 Valsartan tab 80 mg Tablet - - - -
600 Zink tab Tablet 3995 3,995 270 3,725 324 (3,401)
BHP DES 2014 KE DES 2015 - - - -
601 Alat suntik sekali pakai 3cc Pcs 2600 2,600 2,600 - (2,600)
602 Alat suntik sekali pakai 5 ml Pcs 250 250 250 - (250)
603 Alat suntik sekali pakai 1 cc Pcs - - - -
604 Amonium oxalat Botol 100 ml - - - -
605 Bahan Pengobatan untuk pulpa Botol 13 ml - - - -
606 Bahan Pengobatan untuk pulpa (Pulperyl) Botol 13 ml - - - -
607 Bahan Tambalan sementara Pot 30 g - - - -
608 Bahan untuk Perawatan Syaraf Akar Gigi Botol 7.5 g - - - -
609 Blood lancet Box 500 500 500 - (500)
610 Catgut 3/0 Box 36 36 12 24 14 (10)
611 Catgut 2/0 Box - - - -
612 Daryantulle Box - - - -
613 Etakridin Botol 100 ml - - - -
614 Etanol 70 % Botol 1000 ml - - - -
615 Etil klorida Spray Vial/can/100 ml - - - -
616 Glass Ionomer Cement (Fuji) Set - - - -
617 Glass Ionomer Cement ART Box - - - -
618 Handschoen Steril 6.5, 7 dan 7.5 Pasang - - - -
619 Handschoen panjang ginekologi Pasang 100 100 100 - (100)
620 Infusion set anak Pcs - - - -
621 Infusion set dewasa Pcs 78 78 78 - (78)
622 IV cateter no 20 G Pcs 33 33 33 - (33)
623 IV cateter no 22 G Pcs 103 103 103 - (103)
624 IV cateter no 24 G Pcs 130 130 48 82 58 (24)
625 IV Catheter No. 18 G Pcs - - - -
626 Jarum injeksi untuk gigi sekali pakai Pcs 200 200 10 190 12 (178)
627 Kalsium Hidroksida Pasda (Calcidor) Box - - - -
628 Kapas pembalut 250 gram Rol 69 69 2 67 2 (65)
629 Kasa pembalut steril 2 m X 80 cm Rol - - - -
630 Kasa pembalut hidrofil 40 yard x 80 cm Rol 546 546 5 541 6 (535)
631 Kasa pembalut hidrofil 40 yard x 80 cm Rol 40 40 40 - (40)
632 Kasa Hidrofil uk 4 cm x 10 cm Rol 862 862 862 - (862)
633 Kasa Hidrofil uk 4 cm x 10 cm Rol - - - -
634 Larutan injesi untuk gigi (Zeyco) Ampul - - - -
635 Larutan injkesi untuk gigi (Septodont Septocain) Ampul - - - -
636 Larutan Asam Sulfosalisilat 20 % Botol - - - -
637 Larutan Barium Klorida 10 % Botol - - - -
638 Larutan Benedict Botol - - - -
639 Larutan Eosin Botol - - - -
640 Larutan Fauchet Botol - - - -
641 Larutan HCl 0.1 N Botol - - - -
642 Larutan Hayem Botol - - - -
643 Larutan Rees Eckher Botol - - - -
644 Larutan Rokles Botol - - - -
645 Larutan Turk Botol - - - -
646 Larutan metilen Blue Botol - - - -
647 Lisol Botol 1000 ml - - - -
648 Masker Pcs - - - -
649 Masker Earloop Pcs 0 - - - -
650 Masker Tie-on Pcs - - - -
651 Polikresulen ( Albotyl ) Botol 10 m 7 7 7 - (7)
652 Plester 5 yards X 2 inch Rol - - - -
653 Plester 5 yards X 2 inch Rol - - - -
654 Stripe Cholesterol Pcs - - - -
655 Stripe Cholesterol (Autocheck) Pcs - - - -
656 Stripe Glucose Pcs - - - -
657 Stripe Glucose (Autocheck) Pcs - - - -
658 Stripe Tes Kehamilan Pcs - - - -
659 Stripe Uric Acid Pcs - - - -
660 Stripe Uric Acid (Autocheck) Pcs - - - -
661 Silk (Benang Bedah Sutra) N0 3/0 dg jarum bedah Pcs - - - -
662 Tambalan Sementara (Citodur) Pot/30 g - - - -
663 Tes. Widal Set - - - -
664 Zink Phospate Cement Liquid Botol - - - -
665 Zink Phospate Cement Powder Botol - - - -
666 Aquadest Botol - - - -
667 Objek glass Box - - - -
668 Pot Dahak Pcs - - - -
669 Masker N 95 Pcs - - - -
670 Wing Needle Box - - - -
671 Sterile Surgical Blades Pcs - - - -
672 Masker Bedah Pcs - - - -
673 Tabung durham Pcs - - - -
674 Pipet Ukur 10 ml Pcs - - - -
675 Box Sample Pcs - - - -
676 Aluminium Foil Pack - - - -
677 Reagensia LB Botol - - - -
678 Sisa Chlor Set - - - -
679 Reagensia Test PH Set - - - -
680 Reagensia Cadmium Cd Set - - - -
681 Reagensia Nitrat Set - - - -
682 Reagensia Nitrit Set - - - -
683 Reagensia Chlorine Set - - - -
684 Reagensia Pb Set - - - -
685 Reagensia Zn Set - - - -
686 Reagensia Iron Set - - - -
687 Reagensia Fluoride Set - - - -
688 Reagensia mangan Set - - - -
689 Spiritus Botol - - - -
690 Aquadest Botol - - - -
691 Plastik sample 20 cm x 15 cm Pack - - - -
692 Test Kit Makanan dan Minuman (formalin +Borax) Set - - - -
693 Reagensia E Coli Set - - - -
694 Reagensia Metanyl Yellow Set - - - -
695 Reagensia Pestisida Set - - - -
696 Reagensia saccharin Set - - - -
697 Reagensia Siklamat Set - - - -
698 Pot Dahak Pcs - - - -
699 Masker N95 Pcs - - - -
700 Safety Box Buah - - - -
701 Infusion set Dewasa Pcs - - - -
702 Infusion set Anak Pcs - - - -
703 Plester 5 yards X 2 inch Rol - - - -
704 Kasa Pembalut 4 m x 10 cm Rol - - - -
705 Rapid Test HIV SD Box 100 - - - -
706 Rapid Test HIV Oncoprobe Box 50 - - - -
707 Rapid Test Malaria Box 25 test - - - -
708 Rapid Test Syphilis Box 100 - - - -
709 Rapid Test Gonoorrhoe Box 50 - - - -
710 Rapid Test Demam Berdarah Box 25 test - - - -
711 Rapid Test HIV Box 50 - - - -
712 Emulsion Oil Botol 250 ml - - - -
713 Cotton Swab Pcs - - - -
714 Paket Pewarna Garam Set - - - -
715 Reagen Ziehl Nielsen Bottle @ 100 ml - - - -
SISA PENGEMBALIAN OBAT DARI PUSKESMAS - - - -
JKN (SISA PENGEMBALIAN PUSKESMAS) - - - -
716 Aciklovir 400 mg tablet Tablet - - - -
717 Adalat oros tab 20 mg Tablet - - - -
718 Alopurinol tab 100 mg Tablet - - - -
719 Asam Mefenamat 500 mg Tab Tablet - - - -
720 Bedak Salisil Serbuk 2 % Dus 50 g - - - -
721 Cetirizine Tablet Tablet - - - -
722 Ciprofloksasin tablet 500 mg Tablet - - - -
723 Donperidon suspensi/sirup 5 mg/5 ml Botol 60 ml - - - -
724 Fasidol Drops Botol - - - -
725 Furosemide Tablet 40 mg Tablet - - - -
726 Glimepiride 2mg Tablet - - - -
727 Ibuprofen tab 200 mg Tablet - - - -
728 Ibuprofen Suspensi Botol - - - -
729 Lidokain Comp. Injeksi Ampul - - - -
730 Metformin Tablet Tablet - - - -
731 Mometasone salep 10 g Tube 10 g - - - -
732 Nifedipin tablet Tablet - - - -
733 Ofloxacine 400mg Tablet - - - -
734 Omeprazole tab Tablet - - - -
735 Paracetamol 500 mg Tablet - - - -
736 Primolut N tablet Tablet - - - -
737 Ranitidin 150 mg Tablet - - - -
738 Scabimite ( Permetrin) krim 5% Tube 10 g - - - -
739 Sefadroksil syrup Botol 60 ml - - - -
740 Simvastatin Tablet Tablet - - - -
741 - - - -
742 - - - -
751 - - - -
DAK (SISA PENGEMBALIAN PUSKESMAS) - - - -
752 Aciklovir krim 5 % Tube 62 62 62 - (62)
753 Antasida tab Tablet - - - -
754 Anti bakteri DOEN salep Tablet - - - -
755 Betadine Povidone 300 ml Botol 300 ml - - - -
756 Dexametasone tablet Tablet - - - -
757 Epinefrina HCL/Bitarrat inj Ampul - - - -
758 Fenilbutason Tablet - - - -
759 Fitomenadion (Vit K1) tablet salut Tablet - - - -
760 Garam Oralit Sachet - - - -
761 Gentaimisin salep kulit Tube - - - -
762 Glibenclamide Tablet 190 190 40 150 48 (102)
763 Griseofulvin tablet Tablet - - - -
764 Hidrokortison krim 2.5 % Tube - - - -
765 Hyorex tab Tablet - - - -
766 Kotrimoksasol Pediatrik Tablet - - - -
767 Metronidazol 500 mg Tablet 0 - - - -
768 Perfenazin Tab 4 mg Tablet - - - -
769 Piracetam 1200 mg Tablet - - - -
770 Pirantel 125 mg tab Tablet - - - -
771 Salbutamol 2 mg tablet Tablet - - - -
772 Perfenazin Tab 4 mg Tablet - - - -
773 Betamethason krim - - - -
774 Isosorbid 160 160 20 140 24 (116)
775 - - - -
776 - - - -
777 - - - -
778 - - - -
779 - - - -
780 - - - -
PG (SISA PENGEMBALIAN PUSKESMAS) - - - -
781 Sianakobalamin tablet Tablet - - - -
782 Vitamin Bcomp tablet Tablet - - - -
783 Aciklovir 200 mg tablet Tablet - - - -
784 Ambroxol syrup Botol - - - -
785 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml - - - -
786 Antifungi DOEN salep kulit Pot - - - -
787 Antimigren (Ergotamine coffein) Tablet - - - -
788 Cefaleksin kapsul Kapsul - - - -
789 Chloramphenicol Susp Botol - - - -
790 Clindamycin 150 mg Kapsul - - - -
791 Dextromethorpan syrup Botol 60 ml - - - -
792 Diazepam 2 mg Tablet - - - -
793 Diovan Tablet - - - -
794 Doksisiklin tablet Tablet - - - -
795 Donperidon suspensi/sirup 5 mg/5 ml Botol 60 ml - - - -
796 Erythromycin 500 mg caps Kapsul - - - -
797 Gentian Violet 10 Ml. Botol - - - -
798 Ibuprofen tab 400 mg Tablet - - - -
799 Irbesartan 150 mg Tablet - - - -
800 Ketokonazole 2 % krim Tube 15 g - - - -
801 Ketoprofen 100 mg Tablet - - - -
802 Khloramphenicol susp.125 mg/ml Botol 60 ml - - - -
803 Kloramfenikol salep mata 1 % Tube 5 g - - - -
804 Linkomisin kapsul 500 mg Kapsul - - - -
805 Loperamide Tablet - - - -
806 Metoclopramide Tablet 350 350 50 300 60 (240)
807 Natrium Diklofenak tablet Tablet - - - -
808 Nistatin tablet 500.000 IU/g Tablet - - - -
809 Nystatin Vag tab Vagtablet - - - -
810 Oxytetra 1% zalf mata Tube - - - -
811 Oxytetra 3% Zalf Kulit Tube 1 1 1 - 1 1
812 Papaverin Tablet 64 64 34 30 41 11
813 Paracetamol sirup 120 mg/10ml Botol 60 ml - - - -
814 Prednison tablet 5 mg Tablet - - - -
815 Propanolol tablet 40 mg Tablet - - - -
816 Salbutamol 4 Mg Tablet - - - -
817 Salep 2-4 Kombinasi Pot 30 g 46 46 6 40 7 (33)
818 Sefadroksil kapsul/kaplet 500 mg Kapsul - - - -
819 Sianakobalamin tablet Tablet - - - -
820 Vitamin Bcomp tablet Tablet - - - -
821 Zink tab Kapsul - - - -
822 - - - -
823 - - - -
829 - - - -
BHP PG (SISA PENGEMBALIAN PUSKESMAS) - - - -
830 Alat suntik sekali pakai 3cc Pcs - - - -
831 Catgut 3/0 Pcs - - - -
832 Etanol 70 % Botol 1000 ml - - - -
833 Handschoen Steril 6.5 dan 7 Psg - - - -
834 Infusion set anak Pcs - - - -
835 Infusion set dewasa Pcs - - - -
836 IV cateter no 20 G Pcs - - - -
837 IV cateter no 22 G Pcs - - - -
846 - - - -
I. OBAT DAK 2016 - -
852 Allopurinol 100 mb Tablet 1930 1,930 75 1,855
853 Amlodipin Tablet 10 mg Tablet 418 418 9 409 11 (398)
854 Amlodipin tablet 5 mg Tablet 3350 3,350 983 2,367 1,180 (1,187) 1298
855 Amoksisilin Kaplet Scored 500 mg Kaplet 8820 8,820 2,800 6,020 3,360 (2,660) 3080
856 Amoksisilin sirup kering 125mg/5 ml Botol 255 255 120 135 144 9
857 Amoksisilin Sirup Kering Forte 250 mg/5 ml Botol 244 244 15 229 18 (211)
858 Asam Askorbat (Vitamin C) Tablet 250 mg Tablet - - - -
859 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 11128 11,128 1,372 9,756 1,646 (8,110) 1965
860 Besi II Sulfat Tablet 21480 21,480 21,480 - (21,480)
861 Betametason krim 0,1 % (sebagai Valerat) Tube 48 48 9 39 11 (28)
862 Deksametason tablet 0,5 mg Tablet 4806 4,806 791 4,015 949 (3,066)
863 Domperidon suspensi/sirup 5 mg/5 ml Botol - - - -
864 Domperidon tablet 10 mg Tablet - - - -
865 GAVISTAL DROPS- Metoklopramid drop botol 10 ml Botol - - - -
866 Gentamisin Salep Kulit Tube 18 18 7 11 8 (3)
867 Haloperidol Tablet 0,5 mg Tablet - - - -
868 Haloperidol Tablet 1,5 mg Tablet - - - -
869 Ibuprofen tablet 200 mg Tablet - - - -
870 Ibuprofen tablet 400 mg Tablet - - - -
871 Kalium Diklofenat 50 mg Tablet - - - -
872 Klorfeniramina Maleat (CTM) tablet 4 mg Tablet - - - -
873 Klorpromazin Tablet Salut 100 mg Tablet - - - -
874 Klorpromazin Tablet Salut 25 mg Tablet - - - -
875 Kotrimoksazol kombinasi suspensi Botol - - - -
876 Lidokain injeksi 2% (HCl) + Epinefrin 1:80.000 2 ml Ampul 53 53 53 - (53)
877 Meloksikam tablet 15 mg Tablet - - - -
878 Meloksikam tablet 7.5 mg Tablet 845 845 252 593 302 (291)
879 Metformin HCL tablet 500 mg Tablet 1070 1,070 405 665 486 (179)
880 Metilprednisolon tablet 4 mg Tablet 2678 2,678 683 1,995 820 (1,175) 1248
881 Metoklopramid tablet 10 mg Tablet - - - -
882 Metoklopramide sirup 5 mg/5 ml (Lexapram sirup) Botol - - - -
883 Mikonazol Krim/Salep 2 % (Nitrat) Tube - - - -
884 Natrium Diklofenak tablet 50 mg Tablet - - - -
885 Paracetamol syrup 120 mg/5 ml Botol 404 404 160 244 192 (52)
886 Parasetamol tablet 500 mg Tablet - - - -
887 Piridoksin (Vitamin B6) tablet 10 mg (HCl) Tablet 4410 4,410 736 3,674 883 (2,791) 1605
888 Povidon Iodida Larutan 10 % 60 ml Botol 10 10 5 5 6 1
889 Simvastatin Scored tablet 10 mg Tablet - - - -
890 Simvastatin scored tablet 20 mg Tablet - - - -
891 Zinc Tablet Dispersible 20 mg Tablet - - - -
Hypafix 23 23 1 22 1 (21)
II. BHP DAK 2016 - - - -
892 Aquadest Bottle 1000 ml - - - -
893 Bahan Pengisi Untuk Gigi (Meta Biomed Metapex) Pcs - - - -
894 Bahan Pengobatan Untuk Pulpa (Septodont/Pulperyl) Bottle 13 ml - - - -
895 Bahan Perawatan Akar Gigi (Septodont/Creosophate) Bottle 7.5 g - - - -
896 Bahan Tambalan Sementara (Dorident/Citodur) Pot 30 g - - - -
897 BIOMERIEUX SA Rapid Test Vikia HIV 1/2 KIT - - - -
898 COSMOMED Infusion Set (anak) Pcs - - - -
899 COSMOMED Infusion Set (Dewasa) Pcs - - - -
900 Deck Glass (Sail Brand) Box - - - -
901 Ethyl Chlorida Spray 100 ml Botol 12 12 3 9 4 (5)
902 Glass Ionomer (Fuji ART 1X Minipack) Pack 4 4 4 - (4)
903 GP CARE 3-Ply Face Mask With Ear-loops (Jenis Karet) box - - - -
904 GP CARE 3-Ply Face Mask With Tie-On (Jenis Tali) Box 500 500 250 250 300 50
905 Handschoen Gynecology Pasang - - - -
906 HOSPITECH HOSPITECH ID BAND ADULT/CHILD pcs - - - -
907 Jarum Injeksi Gigi Sekali Pakai (CK Jeet) Box - - - -
908 JAYAMAS Onemed Alkohol 70% 1 L Botol - - - -
909 JAYAMAS Onemed Lysol 1 liter Botol - - - -
910 JAYAMAS Onemed Rivanol 300 cc Botol - - - -
911 JAYAMAS Onemed Safety Box Dus - - - -
912 Kapas pembalut 250 gram Pack
913 Larutan Asam Sulfosalisilat 20 % Botol 100 ml - - - -
914 Larutan Barium Klorida 10 % Botol 100 ml - - - -
915 Larutan Benedict Botol 100 ml - - - -
916 Larutan Eosin Botol 100 ml - - - -
917 Larutan Fauchet Botol 100 ml - - - -
918 Larutan Hayem Botol 100 ml - - - -
919 Larutan Injeksi Untuk Gigi (Inibsa/Artinibsa 4 %) Box 100 200 200 200 - (200)
920 Larutan Metilen Blue Botol 100 ml - - - -
921 Larutan Rees Eckher Botol 100 ml - - - -
922 Larutan Turk Botol 100 ml - - - -
923 MPM Medikit Savety IV Catheter Supercath 5 G20 Pcs - - - -
924 Object Glass (Sail Brand) Box - - - -
925 Penutup Luka (Darya Varia) Pcs 25 25 6 19 7 (12)
926 Plester Penutup Luka Lebar (BSN/5 x 1) Roll - - - -
927 Pot Dahak Berulir (Superpack/AA001-14 B) Buah - - - -
928 Reagen Untuk Pemeriksaan HIV 1 (SD/03FK11) Kit - - - -
929 Reagen Untuk Pemeriksaan HIV 2 (Oncoprobe/IR 100C)Kit - - - -
930 Reagensia LB (Merck/1.10285.0500) Botol 500 g - - - -
931 SERENITY Benang Operasi Cromic Catgut with Needle 2.Box - - - -
932 SERENITY Benang Operasi Cromic Catgut with Needle 3.Box 2 2 2 - (2)
933 SERENITY Twist Blood Lancet Box - - - -
934 SINOPHARM SURGICAL SUTURE + NEEDLE SILK BLACK BRDus 31 31 31 - (31)
935 Strip Chlolesterol (Autocheck) Tube 10 4 4 2 2 2 0
936 Strip Glucose (Autocheck) Tube 25 4 4 1 3 1 (2)
937 Strip Tes Kehamilan Box 50 50 50 5 45 6 (39)
938 Strip Uric Acid (Autocheck) Tube 25 3 3 3 - (3)
939 Strip Urine Analisys (Onemed/Combur) Tube 100's - - - -
940 Tabung Reaksi Besar (IWAKI/Test 15-105 NP) Buah - - - -
941 Tabung Reaksi Kecil (IWAKI/Test 12/90 NP) Buah - - - -
942 Test Kit Makanan (Inagenpro) Set - - - -
943 UNION Auto Disable Syringe 0,5 ml Pcs - - - -
944 UNOLAB EURODERM Latex Powdered Surgical Glove 7.0Pasang - - - -
945 UNOLAB EURODERM Latex Powdered Surgical Glove 8.0Pasang - - - -
946 Widal Test (OMEGA Diagnostic) Set 10 vial - - - -
JKN 2016 - - - -
I. OBAT JKN 2016 - - - -
947 Antihaemorroid suppositoria Suppositor 37 37 37 - (37)
948 Asetat Ringer (Asering Plabot) Bag - - - -
949 Azithromycin tablet 500 mg Tablet - - - -
950 Doksisiklin Kapsul 100 mg Kapsul - - - -
951 Gemfibrozil Tablet 600 mg Tablet 80 80 80 - 96 96
952 Glimepiride 2 mg tab Tablet 235 235 235 - 282 282
953 Glukosa larutan infus 5 % Botol - - - -
954 Irbesartan tablet 300 mg Tablet - - - -
955 Irbesartan tablet 150 mg Tablet - - - -
956 Isosorbid Dinitrat 10 mg Tablet - - - -
957 KAEN 3B Bag - - - -
958 Kaptopril Tablet 50 mg Tablet - - - -
959 Kloramfenikol salep mata 1 % Tube - - - -
960 Kodein tablet 10 mg Tablet - - - -
961 NaCl 0.9 % Botol - - - -
962 Obat Anti Tuberculosis FDC Kategori Anak Paket - - - -
963 Obat Anti Tuberculosis FDC Kategori I Paket 11 11 2 9 2 (7)
964 Obat Anti Tuberculosis FDC Kategori I Paket - - - -
965 Ofloksasin Tablet 400 mg Tablet Tablet - - - -
966 Parasetamol Drop 100mg/ml Btl 15 ml 3 3 1 2 1 (1)
967 Retinol Vitamin A 100.000 IU Kapsul - - - -
968 Retinol Vitamin A 200.000 IU Kapsul - - - -
969 Ringer Lactat Botol 42 42 5 37 6 (31)
970 Setirizin Sirup 5 mg/5 ml Botol 11 11 1 10 1 (9)
971 Vitamin B Kompleks Tablet Tablet 1975 1,975 1,885 90 2,262 2,172
Tes gol. Darah paket 1 1 1 -
Cefadroxil 500 mg 1700 1,700 415 1,285
II. BHP JKN 2016 - - - -
972 HOSPITECH HOSPITECH ID BAND ADULT/CHILD Pcs - - - -
973 JAYAMAS ONEMED LYSOL 1 LITER Botol - - - -
974 JAYAMAS ONEMED KAPAS PEMBALUT Rol - - - -
975 JAYAMAS ONEMED BLOOD LANCET Box - - - -
976 JAYAMAS ONEMED U PAD STERIL 60 x 90 cm Blister - - - -
977 LORNE LABORATORIES Salmonella Type H Widal Test (ViaVial - - - -
978 LORNE LABORATORIES Salmonella Type O Widal Test (ViaVial - - - -
979 AXIMED INFUSET Pcs - - - -
980 AXIMED SYRINGE 1 CC Dus - - - -
981 HALONI JANE PROTOS Surgical Sterile Powder Glove (SizePasang - - - -
982 HALONI JANE PROTOS Surgical Sterile Powder Glove (SizePasang - - - -
983 Urynalisis birui 1 1 1 - (1)
984 - - - -
989 ` - -
TOTAL
JUMLAH KUNJUNGAN

Mengetahui Mengetahui Yang Menerima

Kepala UPTD Pengelolaan Obat Kepala Puskesmas Tamangapa Petugas Pengelola Obat

Ade Shinta Dumalang, S.Si. Apt dr. Wiwik Suryani, S.Si, Apt
Nip. 19730428 199203 2 003 Nip. 197210292006042013 Nip. 197801232006042012
asmef
gg 640
amox
vit c
b comp